Be Aware, Be Healthy: What You Need To Know About Swimming In Chlorinated Pools

[Guest guest]

Be Aware, Be Healthy: What You Need To Know About Swimming In

Chlorinated Pools

http://www.medicalnewstoday.com/articles/123713.php

As the mother of a high performance swimmer, I read with great

interest any study about pool environments and health. That's why the

recent study about outdoor pools and asthma by Belgian researchers in

the European Respiratory Journal caught my interest. The study claims

a relationship between outdoor chlorinated swimming pool attendance

and higher risks of asthma in teenagers.

As I read the study, my concerns were lessened when I discovered

these researchers reported no link between asthma and indoor pools.

The authors wrote, " When considering the whole population, no

significant association emerged between asthma and the attendance at

indoor chlorinated pools, whether cumulative over lifetime or during

early childhood. " Since the researchers reported no association of

asthma with indoor pools, why would we expect concerns in outdoor

pools where pool air is open to and mixes with outdoor air? It simply

does not make sense.

I also checked the recent literature and found that a German

researcher reported in the International Journal of Hygiene and

Environmental Health on a large prospective study of 2,100 children.

These German researchers found no link between asthma and chlorinated

pools. In fact, these researchers found, " higher rates of asthma

among those not starting to swim in the 1st year of life. "

I for one do not see anything reported in this Belgian study that

would cause me to remove my child from swimming in indoor or outdoor

pools that are properly maintained and operated.

My opinion is informed by the fact that untreated and under treated

pool water can teem with unwanted " bugs " -the pathogens that cause

problems like diarrhea, swimmer's ear and athlete's foot. The US

Center for Disease Control and Prevention (CDC) MMWR reports the

number of disease outbreaks from recreational water have increased

substantially since 1978, when the government first began collecting

these data. During 2005-2006, there were 4015 reported illnesses from

waterborne disease outbreaks from pools and other aquatic facilities.

Why? Just consider that swimmers often enter pools with substances

such as perspiration, urine, body oils and lotions, on their bodies.

CDC staff estimates that each swimmer brings in about 0.14 g of fecal

matter into the pool-largely because we fail to shower or wash

our 'private parts' with soap and water prior to jumping in the pool.

[How much is in your pool? Multiply 0.14 g by the estimated number of

swimmers in the pool and then multiply by 0.0022 to get pounds of

poop in your pool.] Then add some factor for another obvious source

of fecal matter-the swimmie-the baby diaper. Known NOT to be totally

leak proof, some in the swimming pool industry have started calling

these types of diapers-fecal teabags. My point is not to gross you

out. But rather to impress you with the simple fact: 'poop' can be a

source of potentially deadly pathogens, such as E. coli , Giardia ,

Cryptosporidium and Hepatitis A. Chlorine-based pool disinfectants

play an essential role in eliminating most waterborne germs and

contaminants introduced by swimmers.

I am the Corporate Medical Director for Arch Chemicals. Our business

is to make pool treatment chemicals so that each swimmer can have a

joyful and healthful experience. Chlorine is part of the first line

of defense against germs. If maintained at proper levels throughout

the pool, it starts working right away and kills most bacteria and

viruses within minutes. While ultraviolet light and ozone systems can

enhance water quality and help control some chlorine-resistant

pathogens such as Cryptosporidium, these technologies do not replace

the need for chlorine disinfection.

As a physician, I will continue to recommend swimming for asthmatic

kids as a healthy form of exercise because the exercise benefits

offset any theoretical respiratory risk. In light of this study, I

will emphasize to my patients that there are a few common tips

swimmers can use to check the pool water themselves.

- Sight: Look for water that's clean, clear and blue.

- Touch: Check for tiles that feel smooth and clean.

- Smell: Make sure there are no strong odors.

- Sound: Listen for pool cleaning equipment.

- Taste: Never drink or swallow pool water.

- Common Sense: Do your part to protect yourself and others.

Smell is an important signal. Many swimmers mistakenly blame

the 'chlorine-like' smell on " too much chlorine. " In reality, a

properly operated pool should have little odor. What that 'chlorine-

like' smell means is that there is too much pee, poop, sweat,

sunscreen etc., that has used up the residual disinfectant to form

chloramines that can cause red eyes and itchy skin. What this type of

pool needs is more treatment. Download " Sense " -able Swimming fact

sheet (PDF)

I'll also emphasis to my patients that CDC and many state health

departments have issued Six " PLEAs " to promote Healthy Swimming:

Three " PLEAs " for All Swimmers--Practice these three " PLEAs " to stop

germs from causing illness at the pool:

Please don't swim when you have diarrhea. You can spread germs in the

water and make other people sick. This is especially important for

kids in diapers.

Please don't swallow the pool water. In fact, avoid getting water in

your mouth.

Please practice good hygiene. Take a shower before swimming and wash

your hands after using the toilet or changing diapers. Germs on your

body end up in the water.

Three " PLEAs " for Parents of Young Kids--Follow these three " PLEAs "

to keep germs out of the pool and your community:

Please take your kids on bathroom breaks or check diapers often.

Waiting to hear " I have to go " may mean that it's too late.

Please change diapers in a bathroom or a diaper-changing area and not

at poolside. Germs can spread to surfaces and objects in and around

the pool and cause illness.

Please wash your child thoroughly (especially the rear end) with soap

and water before swimming. Everyone has invisible amounts of fecal

matter on their bottoms that ends up in the pool.

Peggy Nilsson Geimer, MD, FACOEM is Corporate Medical Director for

Arch Chemicals and teaches at Columbia University College of

Physicians and Surgeons and at Yale School of Medicine. Dr. Geimer is

Board Certified in Internal Medicine and Preventive Medicine and is a

Fellow of the American College of Occupational and Environmental

Medicine.